Division of Pediatric Hematology Oncology, Stollery Children Hospital, University of Alberta, Edmonton, AB, Canada,
Indian J Pediatr. 2013 Oct;80(10):832-7. doi: 10.1007/s12098-012-0948-9. Epub 2013 Jan 23.
To assess the outcome of childhood neuroblastoma in India over the last 2 decades, identify management lacunae and suggest remedial measures.
A comprehensive search to identify literature addressing outcome of childhood neuroblastoma from India was performed. International Society of Paediatric Oncology and American Society of Clinical Oncology Annual-Meeting abstracts were hand searched to identify unpublished data. Clinico-demographic and outcome data was extracted.
Outcome of approximately 700 patients has been published over the last 2 decades with predominantly small to moderate single center series from 6 cities. Primarily non-myeloablative multiagent chemotherapy protocols alongwith surgery, have been used for treatment. A large majority of patients had stage III/IV neuroblastoma. Limited diagnostic facilities were available at most centers. Survival outcome of 8.7 to 80 % has been reported with high death and relapse rates alongwith high incomplete control/disease progression and treatment abandonment. Few series have identified prognostic parameters. Few patients with high-risk disease have been adequately treated and cured.
There is a clear need for replicating neuroblastoma outcomes at centers of excellence in other cancer centers, improving diagnostic and laboratory facilities, administering adequate and appropriate contemporary therapy, assessing disease response and improving supportive care. National data management infrastructure along with better financial and social support initiatives are key factors.
评估过去 20 年来印度儿童神经母细胞瘤的治疗结果，确定治疗中的不足之处并提出补救措施。
进行了全面检索，以确定来自印度的儿童神经母细胞瘤治疗结果的文献。还查阅了国际儿科肿瘤学会和美国临床肿瘤学会年会摘要，以确定未发表的数据。提取临床-人口统计学和结果数据。
过去 20 年来，大约 700 名患者的治疗结果已经发表，主要是来自 6 个城市的小到中等规模的单一中心系列研究。主要采用非清髓性多药化疗方案联合手术治疗。大多数患者患有 III/IV 期神经母细胞瘤。大多数中心的诊断设施有限。报道的生存率为 8.7%至 80%，死亡率和复发率高，不完全控制/疾病进展和治疗放弃率高。少数系列研究确定了预后参数。少数高危疾病患者得到了充分治疗和治愈。
需要在其他癌症中心的卓越中心复制神经母细胞瘤的治疗结果，改善诊断和实验室设施，提供足够和适当的当代治疗，评估疾病反应并改善支持性护理。国家数据管理基础设施以及更好的财务和社会支持计划是关键因素。
